
<%@include file="/WebPages/Includes/header.jsp"%>
<%@include file="/WebPages/Includes/startBody.jsp"%>
<%@include file="/WebPages/Includes/tablesorter.jsp"%>
<%@include file="/WebPages/Includes/navbar.jsp"%>
<%@include file="/WebPages/Includes/startMainContent.jsp"%>
<%@include file="/WebPages/Includes/leftSidebar.jsp"%>

<div class="col-lg-8 col-md-8 col-xs-12 col-sm-9">
	<hr>




	<div class="table-responsive"
		style="overflow-x: auto; overflow-y: auto;" id="tableDiv"></div>

	<form id="signUpForm" method="post">
<h1><strong>Contact Details</strong></h1>
		<div class="form-group">
			<label class="control-label" for="cfName">Name</label> <input
				class="form-control" id="cfName" name="cfName"
				placeholder="Name" type="text" />
		</div>
		 <div class="form-group">
			<label class="control-label" for="cfMobile">Contact Number</label> <input
				class="form-control" id="cfMobile" name="cfMobile"
				placeholder="Contact Number" type="text" />
		</div>
		 <div class="form-group">
			<label class="control-label" for="cfEmail">Email</label> <input
				class="form-control" id="cfEmail" name="cfEmail"
				placeholder="Email" type="text" />
		</div>
		  <div class="form-group">
			<label class="control-label" for="cfReason">Contact Reason</label> <input
				class="form-control" id="cfReason" name="cfReason"
				placeholder="Contact Reason" type="text" />
		</div>
		  <div class="form-group">
			<label class="control-label" for="cfType">Type</label> <input
				class="form-control" id="cfType" name="cfType"
				placeholder="Type" type="text" />
		</div>
		 
		<div class="form-group">
			<label class="control-label" for="cfNeedAdvertisement">Do you need to advertize on our website</label> 
			<br><input type="radio" value="1" name="cfNeedAdvertisement">Yes
			<input type="radio" value="0" name="cfNeedAdvertisement">No
			
		</div>
		 
		<button class="btn btn-primary" id="request" type="button">Request</button>
	</form>






</div>

<%@include file="/WebPages/Includes/rightSidebar.jsp"%>
<%@include file="/WebPages/Includes/endMainContent.jsp"%>
<%@include file="/WebPages/Includes/footer.jsp"%>

<!-- custom scripts here -->
<script src="/easyskool/customJS/Login/Request/request.js"></script>

<%@include file="/WebPages/Includes/endBody.jsp"%>